title: Non-compliance and inertia in hypertensive Spaniards at high cardiovascular risk: CUMPLE study.
abstract: OBJECTIVE
  To assess non-compliance (NC) and therapeutic inertia (TI) after 6 months of follow-up in hypertensive patients with poorly controlled blood pressure and high cardiovascular risk.
  
  
  METHODS
  Longitudinal, multicentre study; 3900 uncontrolled hypertensive patients were recruited from 585 primary healthcare centres. Tablets were counted during visits at baseline, 1, 3 and 6 months. A tablet count between 80-100% was considered as compliant. Multivariate logistic regression was performed to determine variables associated with NC and TI.
  
  
  RESULTS
  A total of 3636 patients completed, mean age was 64.8 (SD 10.8) years, 53.7% being male. After one month, 61.8% (60.2-63.4) had uncontrolled blood pressure, 39.5% (37.9-41.1) were NC and 52.3% (50.2-54.4) had TI. At the end of follow-up, uncontrolled blood pressure was 34.6% (33.1-36.1) (p < 0.05), NC was 46.8% (45.2-48.4) (p < 0.05) and TI was 34.2% (31.6-36.8) (p < 0.05). The variable associated with NC was greatest number of antihypertensive treatments (OR 1.09, 95% CI 1.05-1.13, p < 0.001), and variables associated with TI were least number of antihypertensive drugs (OR 0.88, 95% CI 0.84-0.98, p < 0.001) and least number of diseases suffered (OR 0.95, 95% CI 0.92-0.98, p = 0.002).
  
  
  CONCLUSIONS
  Due to the complexity of measuring compliance, we have to assume measurement bias.
  
  
  CONCLUSIONS
  Among uncontrolled hypertensive patients, after completing 6 months follow-up, approximately one out of two patients were NC and one out of three physicians committed TI.
authors.affiliation: La Orden Clinical Management Unit , Huelva , Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Márquez-Contreras
authors.forename: Vicente F
authors.initials: VF
authors.lastname: Gil-Guillén
authors.forename: Mariano
authors.initials: M
authors.lastname: De La Figuera-Von Wichmann
authors.forename: Josep
authors.initials: J
authors.lastname: Franch-Nadal
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Llisterri-Caro
authors.forename: Nieves
authors.initials: N
authors.lastname: Martell-Claros
authors.forename: José Luis
authors.initials: JL
authors.lastname: Martin-De Pablos
authors.forename: José Joaquin
authors.initials: JJ
authors.lastname: Casado-Martinez
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-Gonzalez
authors.forename: Salvador
authors.initials: S
authors.lastname: Pertusa Martínez
authors.forename: Concepción
authors.initials: C
authors.lastname: Carratalá-Munuera
authors.forename: Domingo
authors.initials: D
authors.lastname: Orozco-Beltrán
authors.forename: Adriana
authors.initials: A
authors.lastname: Lopez-Pineda
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents